5. On the Go

Winter Car Seat Safety Tips from the AAP

Winter Car Seat Safety Tips from the AAP

​​​​Winter is a tricky time for car seats. As a general rule, bulky clothing, including winter coats and snowsuits, should not be worn underneath the harness of a car seat.

In a car crash, fluffy padding in a coat immediately flattens out from the force, leaving extra space under the harness. A child can then slip through the straps and be thrown from the seat.

Here are some tips to help strike that perfect balance between keeping little ones warm as well as safely buckled in their car seats.

How to keep your child warm & safe in the car seat

Note: The tips below are appropriate for all ages. In fact, wearing a puffy coat yourself with the seat belt is not a best practice because it adds space between your body and the seat belt.

  • Store the carrier portion of infant seats inside the house when not in use. Keeping the seat at room temperature will reduce the loss of the child’s body heat in the car.
  • Get an early start. If you’re planning to head out the door with your baby in tow on winter mornings, you need an early start. You have a lot to assemble, and your baby may not be the most cooperative. Plus, driving in wintry conditions will require you to slow down and be extra cautious.
  • Dress your child in thin layers. Start with close-fitting layers on the bottom, like tights, leggings or long-sleeved bodysuits. Then add pants and a warmer top, like a sweater or thermal-knit shirt. Your child can wear a thin fleece jacket over the top. In very cold weather, long underwear is also a warm and safe layering option.
    As a general rule of thumb, infants should wear one more layer than adults. If you have a coat on, your infant will probably need a coat, and blanket. Just remember to remove the coat and blanket inside the car before putting your child in the car seat.
  • Don’t forget hats, mittens and socks or booties. These help keep kids warm without interfering with car seat straps. If your child is a thumb sucker, consider half-gloves with open fingers or keep an extra pair or two of mittens handy—once they get wet they’ll make your child colder rather than warmer.
  • Tighten the straps of the car seat harness. Even if your child looks snuggly bundled up in the car seat, multiple layers may make it difficult to tighten the harness enough. If you can pinch the straps of the car seat harness, then it needs to be tightened to fit snugly against your child’s chest.
  • Use a coat or blanket over the straps. You can add a blanket over the top of the harness straps or put your child’s winter coat on backwards (over the buckled harness straps) after he or she is buckled up. Some parents prefer products such as poncho-style coats or jackets that zip down the sides so the back can flip forward over the harness. Keep in mind that the top layer should be removable so your baby doesn’t get too hot after the car warms up.
  • Use a car seat cover ONLY if it does not have a layer under the baby. Nothing bulky should ever go underneath your child’s body or between her body and the harness straps. Be sure to leave your baby’s face uncovered to avoid trapped air and suffocation. Many retailers carry car seat bundling products that are not safe to use in a car seat. Just because it’s on the shelf at the store or sold online does not mean it is safe!
  • Remember, if the item did not come with the car seat, it has not been crash tested and may interfere with the protection provided in a crash. Never use sleeping bag inserts or other stroller accessories in the car seat.
  • Pack an emergency bag for your car. Keep extra blankets, dry clothing, hats and gloves, and non-perishable snacks in your car in case of an on-road emergency or your child gets wet on a winter outing.

Taking a few extra minutes to ensure your car seat is secure and there is nothing bulky between the child and the straps is well worth it. You can then travel with peace of mind.

5. On the Go

Where We Stand: Safety Restraints on the School Bus

To ensure the safety of children while they are being transported to school, the American Academy of Pediatrics (AAP) strongly recommends that all children travel in age-appropriate and properly secured child restraint systems in all motor vehicles.

The AAP has had a long-standing position that new school buses should have safety restraints. Parents should work with school districts to encourage that every new bus be equipped with lap/shoulder seat belt restraints that also can accommodate car seats, booster seats, and harness systems. School districts should provide height- and weight-appropriate car seats and restraint systems for all children of preschool age; these systems include booster seats with a three-point belt.

When districts have policies on seat belt use, children tend to be better behaved and they are less likely to distract the driver.

5. On the Go

Where We Stand: Car Seats For Children

All fifty states require that children ride in car safety seats. The American Academy of Pediatrics (AAP) urges that all newborns discharged from hospitals be brought home in rear-facing car safety seats. The AAP has established car safety seat guidelines for low–birth-weight infants, which include riding in a rear-facing seat and supporting the infant with ample padding around the sides, outside the harness system. A convertible car safety seat is recommended as a child gets older.

Infants and young children always should ride in car safety seats—preferably in the backseat. Never use a rear-facing car seat in the front seat of a vehicle equipped with a passenger-side air bag. An infant or child should never ride in an adult’s arms. Children age 12 and younger should ride in the rear seat.

Older children should use booster seats until the vehicle seat belt fits well. This means that the child can sit all the way back on the vehicle seat with knees bent at the edge, the shoulder belt crosses the middle of the chest, the lap belt lies low and snug across the thighs, and the child can sit this way for the entire ride. This position helps avoid injuries to the neck and internal organs from the seatbelt in case of a crash.

5. On the Go

Walking and Biking to School

son dad walkiing to school

Walking and bike riding are healthy ways to get to and from school. Skipping the school drop-off traffic for more active commutes can contribute to the recommended 60 minutes of physical activity kids need each day. Trips powered by feet, rather than vehicles, also can help reduce pollution, which can trigger breathing problems in children. Walking can also help make neighborhoods friendlier places.

Here’s what parents need to know to keep kids safe as they walk or bike to school.

Walking to School

Is my child ready to walk to school alone?

Children usually aren’t ready to start walking to school without an adult until about fifth grade, or around age 10. Younger children are more impulsive and less cautious around traffic, and they often don’t fully understand other potential dangers they could come across.

By walking with your children to and from school, you can help them learn the neighborhood, teach them about traffic signs, street signs and directions, and model correct behaviors when crossing streets. It’s also a great opportunity for some chat time with your kids.

Keep these tips in mind when walking with your young child to and from school:

  • When crossing streets, hold your child’s hand and always observe the traffic safety laws.
  • Observe all traffic signals and let the school crossing guard help you.
  • Be sure to look all ways before crossing the street, and continue to watch for vehicles. Remind children drivers may not always see them.
  • Consider starting a walking school bus by inviting families in your neighborhood to walk children to school together as a group. Adults may take turns walking with the group, so make sure each child knows the adults in their walking group.

Tweens and teens: Walking to school safely

Children are each different, so consider their individual developmental and maturity level when deciding if it is safe for them to walk to school without an adult. Some children may not have the skills to focus on safe pedestrian behavior until they are 10 or older.

For students walking to school without an adult, some points to consider:

  • Make sure they stick to a safe route to school, one with well-trained adult crossing guards at every intersection.
  • If they need to cross any streets on the way to school, practice safe street crossing with them before the start of school.
  • Ideally, they should walk with at least one neighbor child or older sibling.
  • Make sure they know how to say “no” if someone they don’t know offers a ride, and that they yell and run for help if needed.
  • Explain to them that it is not safe to use a cell phone or text while walking, which makes them less aware of traffic.
  • Choose brightly colored backpacks, jackets and other accessories, ideally with reflective materials for days when it begins to get dark earlier.

Biking to school

Bike riding is also a great way to get to and from school, when children are ready. Remember kids need to learn to be safe pedestrians before they can be safe bicyclists.

Once they’re ready to roll, here are some basic bicycle safety steps to help keep them safe:

  • Rules of the road. All bicycle riders should follow the basic rules of the road, which also apply to skateboards, scooters and other non-motorized vehicles:
    • Ride on the right, in the same direction as traffic using bike lanes when available.
    • Stop and look both ways before entering the street.
    • Stop at all intersections, whether marked or unmarked.
    • Respect traffic lights and stop signs.
    • Before turning, use hand signals and look in every direction.
  • Use your head. Always wear a bicycle helmet, no matter how short or long the ride. The helmet should be approved by the Consumer Product Safety Commission and fits correctly.
  • Riding ready? Ride with younger children, and don’t let them ride on the street. Use your judgment about letting older children ride in traffic. Consider how heavy road traffic is where they’ll be riding, how mature they are, and how well they can stay focused on traffic and follow rules of the road.
  • Practice ahead of time. Practice the bike route to school before the first day of school to make sure your child can manage it.
  • See the light. Children should only ride a bike when there is plenty of daylight. Wear white or bright-colored clothing to increase visibility.
  • Distracted riders. Remind bike riders not to talk on the cell phone or text while riding and avoid other distractions like eating.
  • Bike maintenance. Show children how to check tire air pressure, brakes, and seat and handlebar height and do these things at least once a year.


Walking and biking to school helps keep children and their communities happy and healthy. Parents can support and encourage community programs with resources offered through organizations such as Safe Routes to School. These include walkability checklists to score your community, for example, and national events such as Bike to School Day each spring and Walk to School Day in fall.

5. On the Go

Travel Safety Tips

​Traveling with children can be a delight and a challenge. The American Academy of Pediatrics (AAP) has the following tips for safe and stress-free family travel.

Traveling by Airplane

  • Allow your family extra time to get through security – especially when traveling with younger children.
  • Have children wear shoes and outer layers of clothing that are easy to take off for security screening. Children younger than 12 years are not required to remove their shoes for routine screening.
  • Strollers can be brought through airport security and gate-checked to make travel with small children easier.
  • Talk with your children about the security screening process before coming to the airport. Let them know that bags (backpack, dolls, etc.) must be put in the X‑ray machine and will come out the other end and be returned to them.
  • Discuss the fact that it’s against the law to make threats such as; “I have a bomb in my bag.” Threats made jokingly (even by a child) can delay the entire family and could result in fines.
  • Arrange to have a car seat at your destination or bring your own along. Airlines will typically allow families to bring a child’s car safety seat as an extra luggage item with no additional luggage expense. Check the airline’s website ahead of time so you know their policy before you arrive at the airport
  • When traveling on an airplane, a child is best protected when properly restrained in a car safety seat appropriate for the age, weight and height of the child. Children who weigh more than 40 lbs can use the aircraft seat belt. The car safety seat should have a label noting that it is FAA-approved. Belt-positioning booster seats cannot be used on airplanes, but they can be checked as luggage (usually without baggage fees) for use in rental cars and taxis.
  • Although the FAA allows children under age 2 to be held on an adult’s lap, the AAP recommends that families explore options to ensure that each child has her own seat. If it is not feasible to purchase a ticket for a small child, try to select a flight that is likely to have empty seats where your child could ride buckled in her car seat.
  • Pack a bag of toys and snacks to keep your child occupied during the flight.
  • In order to decrease ear pain during descent, encourage your infant to nurse or suck on a bottle. Older children can try chewing gum or drinking liquids with a straw.
  • Wash hands frequently, and consider bringing hand-washing gel and disinfectant wipes to prevent illnesses during travel.
  • Consult your pediatrician before flying with a newborn or infant who has chronic heart or lung problems or with upper or lower respiratory symptoms.
  • Consult your pediatrician if flying within 2 weeks of an episode of an ear infection or ear surgery. 

International Travel

  • If traveling internationally, check with your doctor to see if your child might need additional vaccines or preventive medications, and make sure your child is up-to-date on routine vaccinations. Bring mosquito protection in countries where mosquito-borne diseases such as malaria are present.
  • In order to reduce jet lag, adjust your child’s sleep schedule 2-3 days before departure. After arrival, children should be encouraged to be active outside or in brightly lit areas during daylight hours to promote adjustment.
  • Stay within arm’s reach of children while swimming, as pools may not have safe, modern drain systems and both pools and beaches may lack lifeguards.
  • Ensure that your child wears a life jacket when on smaller boats, and set an example by wearing your life jacket.
  • Conditions at hotels and other lodging may not be as safe as those in the U.S. Carefully inspect for exposed wiring, pest poisons, paint chips, or inadequate stairway or balcony railings.
  • When traveling, be aware that cribs or play yards provided by hotels may not meet current safety standards. If you have any doubt about the safety of the crib or play yard, ask for a replacement or consider other options. (Also applies to travel in the U.S.)

Traveling by Car

  • Road travel can be extremely hazardous in developing countries. Make sure each passenger is buckled and that children use the appropriate car seat. Let your driver know you are not in a hurry, ask that there be no cell phone use, and emphasize that you will reward safe driving.
  • Always use a car seat for infants and young children. All infants and toddlers should ride in a rear-facing car seat as long as possible, until they reach the highest weight or height allowed by the car seat manufacturer. Once your child has outgrown the rear-facing height or weight limit, she should ride in a forward-facing car seat. Updated recommendations on safe travel can be found here.
  • Most rental car companies can arrange for a car seat if you are unable to bring yours along. However, they may have a limited selection of seats. Check that the seat they provide is appropriate for the size and age of your child, that it appears to be in good condition, and that the instruction manual is provided before accepting it.
  • A child who has outgrown her car seat with a harness (she has reached the top weight or height allowed for her seat, her shoulders are above the top harness slots, or her ears have reached the top of the seat) should ride in a belt-positioning booster seat until the vehicle’s seat belt fits properly (usually when the child reaches about 4′ 9″ in height and is between 8 to 12 years of age).
  • All children under 13 years of age should ride in the rear seat of vehicles.
  • Never place a rear-facing car seat in the front seat of a vehicle that has an airbag.
  • Set a good example by always wearing a seat belt, even in a taxi.
  • Children often become restless or irritable when on a long road trip. Keep them occupied by pointing out interesting sights along the way and by bringing soft, lightweight toys and favorite music for a sing-along.
  • Plan to stop driving and give yourself and your child a break about every two hours.
  • Never leave your child alone in a car, even for a minute. Temperatures inside the car can reach deadly levels in minutes, and the child can die of heat stroke
  • In addition to a travelers’ health kit, parents should carry safe water and snacks, child-safe hand wipes, diaper rash ointment, and a water- and insect-proof ground sheet for safe play outside.
5. On the Go

Shopping for Car Seats: Tips for Parents

​​​When shopping for a car seat, keep the following tips in mind:

  • No one seat is the “best” or “safest.” The best seat is the one that fits your child’s size, is correctly installed, fits well in your vehicle, and is used properly every time you drive.
  • Don’t decide by price alone. A higher price does not mean the seat is safer or easier to use.
  • Avoid used seats if you don’t know the seat’s history.

Never use a car seat that:

  • Is too old. Look on the label for the date the seat was made. Check with the manufacturer to find out how long it recommends using the seat.
  • Has any visible cracks on it.
  • Does not have a label with the date of manufacture and model number. Without these, you cannot check to see if the seat has been recalled.
  • Does not come with instructions. You need them to know how to use the seat. Instructions can be found on manufacturer websites or by contacting the manufacturer.
  • Is missing parts. Used car safety seats often come without important parts. Check with the manufacturer to make sure you can get the right parts.
  • Was recalled. You can find out by calling the manufacturer or contacting the National Highway Traffic Safety Administration (NHTSA) Vehicle Safety Hotline at 888/327-4236. You can also visit the NHTSA Website.
  • Do not use seats that have been in a moderate or severe crash. Seats that were in a minor crash may still be safe to use, but some car safety seat manufacturers recommend replacing the seat after any crash, even a minor one. The NHTSA considers a crash minor if all the following situations are true:
  • The vehicle could be driven away from the crash.
  • The vehicle door closest to the car safety seat was not damaged.
  • No one in the vehicle was injured.
  • The airbags did not go off.
  • You can’t see any damage to the car safety seat.
  • If you have specific questions about the car seat, contact the manufacturer.
5. On the Go

Seat Belts for Older Children

​Seat belts are made for adults. Children should stay in a booster seat until adult seat belts fit correctly. Typically, this is when when children reach about 4 feet 9 inches in height and are 8 to 12 years of age. Most children will not fit in a seat belt alone until 10 to 12 years of age. 

When children are old enough and large enough to use the vehicle seat belt alone, they should always use lap and shoulder seat belts for the best protection. All children younger than 13 years should ride in the back seat.​

Using a Seat Belt:

An adult seat belt fits correctly when:

  • The shoulder belt lies across the middle of the chest and shoulder, not the neck or throat.
  • The lap belt is low and snug across the upper thighs, not the belly.
  • Your child is tall enough to sit against the vehicle seat back with her knees bent over the edge of the seat without slouching and can comfortably stay in this position throughout the trip.​

Other points to keep in mind when using seat belts include:

  • Make sure your child does not tuck the shoulder belt under her arm or behind her back. This leaves the upper body unprotected and adds extra slack to the seat belt system, putting your child at risk of severe injury in a crash or with sudden braking.
  • Never allow anyone to “share” seat belts. All passengers must have their own car safety seats or seat belts.

Common Question:

I’ve seen products that say they can help make the seat belt fit better. Should we get one of these?

  • No, these products are unapproved and should not be used. They may actually interfere with proper seat belt fit by causing the lap belt to ride too high on the stomach or making the shoulder belt too loose. They can even damage the seat belt. This rule applies to car safety seats too; do not use extra products unless they came with the seat or are specifically approved by the seat manufacturer. These products are not covered by any federal safety standards, and the AAP does not recommend they be used. As long as children are riding in the correct restraint for their size, they should not need to use additional devices.​
5. On the Go

Safe Shopping with Children

There are definitely some things you should put in your shopping cart in the name of your child’s health and well-being. Your precariously placed child should not be one of them—especially given that more than 20,000 children a year are treated in US emergency departments for reported shopping cart–related injuries!

A majority involve either shopping carts tipping over or sudden falls that occurred within the presence of a watchful adult. To play it safer, consider alternatives to toting your kids around in shopping carts, such as the use of a stroller, wagon, baby carrier, or sling; getting your child to walk the aisles; leaving them at home (with appropriate supervision, of course); or even shopping online.

If you do choose to cart your child, look for the kid-friendly carts that are low to the ground and often conveniently fashioned after fire trucks or race cars. Also buy in to the following rules, which bear a striking and necessary resemblance to those used on just about every amusement park ride we’ve ever been on.

  • Buckle Up. All children should be securely buckled up before the ride begins.
  • Remain Seated. Children should remain seated at all times.
  • In It for the Ride. No one is to ride on the outside of the cart or the ride will come to an immediate halt.
  • Keep Contained. All hands and feet are to be kept inside the cart at all times.
  • Drive Responsibly. Only responsible adults should be in charge of operating the ride.
5. On the Go

Safe RV Travel with Children

​​​Safe RV road trips begin by buckling seat belts, using car seats

Traveling across the country in a recreational vehicle (RV) can be exciting for kids of all ages. To keep everyone safe in your home on wheels, be sure to use seat belts and car seats.

When buying or renting an RV, families should look for safe seating arrangements for everyone, said Benjamin D. Hoffman, M.D., FAAP, a pediatric transportation safety expert and American Academy of Pediatrics (AAP) member.

“That’s certainly the best, that you have a forward-facing seating position with a seat belt available for any passenger, whether they’re going to be riding in a car seat, booster seat or just in a seat belt,” he said.

Families can use AAP car seat guidance when selecting a seat for their child. 

The following is additional safety advice for RV travel:

  • Do not sit on side- or rear-facing benches when the RV is moving. “Car seats and booster seats are only approved for use in a forward-facing vehicle seat using either a seat belt to attach it or the lower anchor attachment,” Dr. Hoffman said.
  • Choose an RV that meets Federal Motor Vehicle Safety Standard 208. These RVs have type 2 (lap and shoulder) belts in all forward-facing seating positions. Type 1 belts (lap only) are not safe for children.
  • Tow the RV or drive a second car. If there aren’t enough safe seating positions for everyone, bring a second vehicle or rent a tow-behind style RV.
  • Don’t distract the driver. Drivers must focus on the road. RVs have a longer stopping distance, maneuver differently and take longer to avoid road hazards.
  • Remember the laws of physics. “It’s a house on wheels, and there’s a ton of stuff,” Dr. Hoffman said. “If a vehicle is moving 60 mph, everything inside the vehicle is moving 60 mph, including the passengers, the blender and everything else. If you’re unrestrained at any point, you’re a potential human missile.” RVs also are prone to rolling over, the most dangerous type of crash, Dr. Hoffman said.

“Parents should strive to be just as safe with their kids in the RV and do exactly what they would do in their passenger vehicle in that RV.”

5. On the Go

Prevent Child Deaths in Hot Cars

Prevent Child Deaths in Hot Cars

​A child left in a hot car–or who gets into an unlocked vehicle unnoticed–can die of heat stroke very quickly. Dozens of U.S. children lose their lives this way each year. But these tragedies can be prevented.

Here is what parents need to know about the danger of hot cars, and steps they can take to help keep their children safe.

Facts about hot cars & heat stroke

  • Heat stroke is the leading cause of non-crash, vehicle-related deaths in children under 15. Heat stroke happens when the body is not able to cool itself quickly enough.
  • A child’s body heats up three to five times faster than an adult’s does.
    • When left in a hot car, a child’s major organs begin to shut down when his temperature reaches 104 degrees Fahrenheit (F).
    • A child can die when his temperature reaches 107 degrees F.
  • Cars heat up quickly! In just 10 minutes, a car can heat up 20 degrees F.
  • Cracking a window and/or air conditioning does little to keep it cool once the car is turned off.
  • Heat stroke can happen when the outside temperature is as low as 57 degrees F.

Things you can do to prevent the unthinkable

Keep in mind: Any parent or caregiver, even a very loving and attentive one, can forget a child is in the back seat. Being especially busy or distracted or having a change from the usual routine increases the risk.

Here are some safety reminders from the American Academy of Pediatrics:

  • Always check the back seat and make sure all children are out of the car before locking it and walking away.
  • Avoid distractions while driving, especially cell phone use.
  • Be extra alert when there is a change in your routine, like when someone else is driving your child or you take a different route to work or child care.
  • Have your child care provider call if your child is more than 10 minutes late.
  • Put your cell phone, bag, or purse in the back seat, so you check the back seat when you arrive at your destination.
  • If someone else is driving your child, always check to make sure he has arrived safely.
  • Keep your car locked when it is parked to prevent a curious child from entering when no one is around. Many hot car deaths have occurred when a child mistakenly locks himself inside.
  • Make sure children do not have easy access to your car keys. Store them out of a child’s reach.
  • Teach children that cars are not safe places to play.
  • Keep rear fold-down seats closed to prevent a child from crawling into the trunk from inside the car.
  • Remind children that cars, especially car trunks, should not be used for games like hide-and-seek.

Important Tip: If a child is missing, always check the pool first, and then the car, including the trunk!

​Take action if you ​​see a child alone in a ​car​If you see an unattended child in a car and are concerned, you should immediately call 911.If the child is not responsive or is in pain, immediately:
Call 911.Get the child out of the car.
Spray the child with cool water (not in an ice bath).If the child is responsive:​​
Stay with the child until help arrives.Have someone else search for the driver or ask the facility to page them.​

​Know the laws in your state:

Although legislation has been introduced, there is currently no federal law in place to prevent child heat stroke deaths in cars. However, many states have passed ​laws that set limits on whether or how long a child can be left in a car. This is especially common in warm-weather states. For example, in California, children under seven can’t be left alone in any vehicle unless supervised by someone who’s at least 12 years old. In Florida, children under six cannot be left alone in a vehicle longer than 15 minutes if the car is turned off, and if the vehicle is running, the child can’t be left alone inside it at all.